Abstract
Background: The number of voids within the root canal obturation is a relevant parameter to describe the quality of the technique, as well as to predict long-term prognosis. The aim of this study was to evaluate the quality of root canal obturation in curved root canals filled with Thermafil, GuttaCore, GuttaFusion and lateral compaction with AH Plus and EndoSequence BC sealer, by means of percentage of gutta-percha and sealer filled area. Methods: 200 curved canals of mandibular molars were divided in five groups (n = 40). Each specimen was evaluated at 3, 6 and 9 mm from the apex. A total of 600 samples were analyzed. Obturation was performed with either Thermafil (TH), GuttaCore (GC), GuttaFusion (GF) or lateral compaction (LC), using AH Plus as sealer. In another group EndoSequence BC sealer (BC) was used. Subgroups (n = 20) were made depending on the use of sonic activation during the placement of the sealer. The percentage of total obturation material was analyzed as an indirect measurement of percentage of voids. Results: GF showed a better performance at the apical level, while GC showed the higher percentage of total obturation at the coronal area. No differences were observed for the activation of sealers in any of the groups. Statistical analysis was performed by using two-way ANOVA. Statistical significance was set at CI: 95% (p < 0.05). Conclusions: Sonic activation of sealers did not show any benefit to avoid the presence of voids within obturation of curved canals. Following the manufacturer recommendations, we found that TH did not show benefits when applied to curved canals.
Highlights
An in vitro randomized trial was designed based on our previous publication [5] and following the same methodology in which three obturation systems were compared (GuttaCore (GC), GuttaFusion (GF)
Lateral condensation (LC)) by means of PGFA, percentage of sealer filled areas (PSFA) and voids through coronal, middle and apical histological slices of 120 mandibular curved root canals corresponding to 360 histological slices and 720 image analysis: 360 acquired through confocal laser scanning microscopy (CLSM) and epifluorescence method (Leica TCS SP5; Leica Microsystems GmbH, Mannheim, Germany) and 360 with an operating microscope at 30× as referencing images
For the obturation of the new specimens, rhodamine-B was weighted with a laboratory micro weighing scale and added to AH Plus (Dentsply DeTrey Gmbh, Konstanz, Germany) and EndoSequence BC sealers (0.1%), to facilitate fluorescence with confocal microscopy
Summary
Given that obtaining total disinfection of the root canal system is not completely achievable [2], it is critical to aim for a threedimensional root canal filling with a tight seal impermeable to fluids, to prevent oral and apical microleakage, minimizing the chances of relapsing endodontic infections [1] For this purpose, many techniques have been widely studied and described in the literature, such as lateral compaction [3] or carrier-based Thermafil (Dentsply Sirona, Ballaigues, Switzerland) [4]. The aim of this study was to evaluate the quality of root canal obturation in curved root canals filled with Thermafil, GuttaCore, GuttaFusion and lateral compaction with AH Plus and EndoSequence BC sealer, by means of percentage of gutta-percha and sealer filled area. No differences were observed for the activation of sealers in any of the groups
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